The patient is a young female who presented at Sultan Qaboos University Hospital, Oman, with symmetrical joint pains, erythema nodosum and episcleritis. She was suspected to have sarcoidosis and a computed tomography (CT) chest scan was performed to look for mediastinal lymphadenopathy. The mediastinum showed evidence of enlarged lymph nodes. Incidentally detected was a bronchus arising from the trachea a short distance before the carina. The tracheal bronchus is seen to arise from the right posterior wall of the trachea cidence of 0.1-3%.² Most of the tracheal bronchi are asymptomatic; however, some children with tracheal bronchus may suffer from stridor, recurrent infections and respiratory distress. In adults, this condition may be associated with difficulties in intubation and ventilation during anaesthesia. Accidental intubation of the tracheal bronchus may lead to inadequate ventilation of the rest of the lung. It may also cause overinflation of the lobe supplied by the tracheal bronchusmand pneumothorax. Accidental occlusion of the tra-cheal bronchus by the endotracheal tube can lead to atelectasis of the involved lobe. If patient is aware of this condition, the anaesthesiologist should be alerted prior to any elective surgery to allow precautions to be taken.